Xie Yuhan, Bai Ruimin, Ren Landong, Fan Hengtong, Tuo Huihui, Duan Longmei, Zhou Xiaolin, Fang Chengyu, Li Ziyan, Zheng Yan
Department of Dermatology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
Department of Urology, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China.
J Cosmet Dermatol. 2025 Apr;24(4):e70176. doi: 10.1111/jocd.70176.
Hair loss disorders, including non-cicatricial forms such as alopecia areata (AA) and androgenetic alopecia (AGA), as well as cicatricial forms, represent significant dermatological concerns influenced by various factors, including lipid metabolism. While observational studies and clinical trials have suggested a link between lipid levels and hair loss, the causal relationship remains unclear.
We conducted a comprehensive analysis of 983 lipid variables [including triglycerides (TG), fatty acids, cholesterol, cholesterol esters, phospholipids, and lipoproteins] and 4 hair loss disorders. Two-sample univariable Mendelian randomization (UVMR) and multivariable Mendelian randomization (MVMR) analyses were employed to investigate the causal effects of lipids on hair loss disorders. Sensitivity analyses were performed to ensure the robustness of our findings.
The UVMR analysis identified 56 significant causal associations between lipid levels and hair loss disorders, with cholesterol, high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), TG, apolipoprotein A1, apolipoprotein B, and lipoprotein(a) emerging as key contributors. The MVMR analysis evaluated the independent effects of HDL-C, LDL-C, and TG on alopecia disorders, identifying significant associations only between HDL-C, TG, and AA. Sensitivity analyses confirmed the consistency and robustness of these results.
This study provides strong evidence for potential causal associations between lipids and hair loss disorders, highlighting potential therapeutic targets and the importance of lipid management in affected patients.
脱发疾病，包括非瘢痕性形式如斑秃（AA）和雄激素性脱发（AGA）以及瘢痕性形式，是受包括脂质代谢在内的多种因素影响的重要皮肤病学问题。虽然观察性研究和临床试验表明脂质水平与脱发之间存在联系，但因果关系仍不清楚。
我们对983个脂质变量（包括甘油三酯（TG）、脂肪酸、胆固醇、胆固醇酯、磷脂和脂蛋白）和4种脱发疾病进行了全面分析。采用双样本单变量孟德尔随机化（UVMR）和多变量孟德尔随机化（MVMR）分析来研究脂质对脱发疾病的因果效应。进行敏感性分析以确保我们研究结果的稳健性。
UVMR分析确定了脂质水平与脱发疾病之间的56个显著因果关联，胆固醇、高密度脂蛋白胆固醇（HDL-C）、低密度脂蛋白胆固醇（LDL-C）、TG、载脂蛋白A1、载脂蛋白B和脂蛋白（a）成为关键因素。MVMR分析评估了HDL-C、LDL-C和TG对脱发疾病的独立影响，仅确定HDL-C、TG与AA之间存在显著关联。敏感性分析证实了这些结果的一致性和稳健性。
本研究为脂质与脱发疾病之间潜在的因果关联提供了有力证据，突出了潜在的治疗靶点以及脂质管理对受影响患者的重要性。
